A digest of events, trends, issues, ideas and journalism from and about rural America, by the Institute for Rural Journalism and Community Issues, based at the University of Kentucky.
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Wednesday, March 30, 2016

Saying efforts to fight heroin and opioid addiction are grossly underfunded, President Obama called on Congress "to open the purse strings to help expand treatment, particularly in rural areas, and applauded bipartisan legislation designed to combat the problem," Jeff Mason reports for Reuters. Obama, who was speaking on a panel at a drug summit Tuesday in Atlanta, "said opioid overdoses killed more people in the U.S. than traffic accidents did and compared the importance of addressing the issue to that of fighting Islamic State militants." He said, "It's costing lives, and it's devastating communities."

Mason writes, "Obama, who earlier this year asked the U.S. Congress for $1.1 billion in new funding over two years to expand treatment for the epidemic, has faced criticism for not doing more to fight the problem sooner." The U.S. Department of Agriculture this week made $1.4 million in grants available to rural communities to fight heroin and painkiller abuse.

Obama said on Tuesday: "Part of what is troubling about the opioids epidemic is that we're
seeing significantly higher spikes in rural areas. And part of that is
because there has been a lot of under-resourcing of treatment
facilities, mental health facilities. There may be, in some of those
cases, more stigma than there might be in big cities about getting help.
If you're in a small town, everybody kind of knows you—you may be
more hesitant, right? I don't know if that's an experience that you
felt."
Treatment needs to be available in every county in the U.S., Obama said. "The problem we have right now is that treatment is
greatly underfunded. And it's particularly underfunded in a lot of
rural areas. Our task force, when we were looking at it, figured out
that in about 85 percent of counties in America, there are just a
handful or no mental health and drug treatment facilities that are
easily accessible for the populations there."

"So if you get a situation
in which somebody is in pain initially because of a disk problem, they
may not have health insurance because maybe the governor didn't expand
Medicaid like they should have under the ACA—they go to a doctor
one time when the pain gets too bad, the doctor is prescribing
painkillers, they run out, and it turns out it's cheaper to get heroin
on the street than it is to try to figure out how to refill that
prescription, you've got a problem," he said. "And that's why, for all the good
work that Congress is doing, it's not enough just to provide the
architecture and the structure for more treatment. There has to be
actual funding for the treatment. And we have proposed in our budget an
additional billion dollars for drug treatment programs in counties all
across the country."

Also participating in the panel was Crystal Oertle, a mother of two from rural Shelby, Ohio, (Best Places map) who became addicted to opioids. She said her story is similar to that of many people—she started using painkillers recreationally and eventually became addicted. "It slowly happened from weekend to
then needing it throughout the week, needing something to go to work," she said. "Eventually I needed something stronger than the Vicodin. I was doing
OxyContins, Dilaudid, things like that, until that eventually led into
me doing heroin. And the higher milligram
things like Oxycontin and Dilaudid to me are pretty much like heroin.
They’re like synthetic heroin—almost as strong. So when it came to
the point and I couldn’t find those kinds of pills, I had to go to the
street to prevent my withdrawal symptoms, so that I could participate in
my life—my children, getting them to school, me going to work. So
that’s how I got into using heroin after the pills."

Obama said, "What we have to recognize is, in this global economy of ours that the
most important thing we can do is to reduce demand for drugs. And the only way that we reduce demand is if we're providing
treatment and thinking about this as a public health problem and not
just a criminal problem. Now, this is a shift that began very early on
in my administration. And there's a reason why my drug czar is somebody
who came not from the criminal justice side but came really from the
treatment side—and himself has been in recovery for decades now."

"Part of what has made it previously difficult to emphasize treatment
over the criminal justice system has to do with the fact that the
populations affected in the past were viewed as, or stereotypically
identified as poor, minority, and as a consequence, the thinking was it
is often a character flaw in those individuals who live in those
communities, and it's not our problem they're just being locked up," Obama said. "And I
think that one of the things that's changed in this opioid debate is a
recognition that this reaches everybody."

The only good news about the drug epidemic is that it's affecting so many people in so many areas that "we're seeing a bipartisan interest in addressing this problem—not just
taking a one-size-fits-all approach, not just thinking in terms of
criminalization and—which, unfortunately, too often has been the
response that we have to a disease of addiction—but rather, we've got an
all-hands-on-deck-approach increasingly that says we've got to stop
those who are trafficking and preying on people, but we also have to
make sure that our medical community, that our scientific community,
that individuals—all of us are working together in order to address this
problem," Obama said. (Read more)

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This blog generally follows traditional journalistic standards. It's not about opinions, though you may read one here occasionally. It's about facts that we think will be useful to rural journalists, non-rural journalists who do rural stories, and others interested in rural issues. We don't try to be provocative, so we don't generate as many comments as most blogs with the level of traffic we have, but we certainly invite comments -- and contributions, to al.cross@uky.edu. Feel free to republish blog items, with credit to us and the original source.